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At the heart of general practice since 1960

Oxford medical school director: 'The variation in GP numbers between medical schools is not undesirable'

Dr Tim Lancaster, a GP and the director of clinical studies at the University of Oxford medical school, explains why just 16% of its students go onto become GPs

Although numbers entering training for general practice is relevant, it is also important to look at completion rates. Analysis of results of the MRCGP shows that for the past eight years, Oxford graduates have had the highest success rate in the country in both the knowledge and clinical skills components of this exit examination.

As a GP myself, I am delighted that our course is so successful in equipping graduates to be excellent primary care doctors.

There is strong evidence that the GP recruitment crisis is related to deterioration in funding and working conditions in the specialty, and much less to what goes on in medical school.

We have analysed the career destinations of our graduates over 50 years. In the 1980s over 40% of Oxford graduates chose general practice, a time when working conditions were good and opportunities in other specialties were limited (and, incidentally, there was almost no general practice in the medical school curriculum). The expansion in the consultant workforce since the 1990s offers a wide range of opportunities to doctors of talent.

If general practice is to compete with other specialities in attracting the best doctors, conditions and funding need to improve. Fix the job and the recruitment crisis will fix itself.

It is unacceptable to have variations in standards between medical schools. However, we do not agree that it is undesirable that there is variation between schools in the proportion of graduates entering different career paths. Oxford unashamedly selects students who have the potential to benefit from a course which places strong emphasis on the understanding of biomedical research.

As well as excellent clinicians, the course aims to nurture graduates capable of developing a research career and of contributing to the scientific advances that improve health and wealth. The NHS needs a vibrant life sciences sector just as much as it needs a strong primary care workforce. I am very pleased when some of our best graduates tell me they are applying for general practice training, but I would be disappointed if they all did.

Dr Tim Lancaster is a GP and the director of clinical studies at the University of Oxford medical school

Readers' comments (11)

  • Excellent piece that cuts through all the tosh spouted on this topic.
    I am glad Oxford unashamedly pursues excellence for their particular cohort of students.

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  • "Oxford unashamedly selects students who have the potential to benefit from a course which places strong emphasis on the understanding of biomedical research." OK - but maybe you should suspend that form of selection as it is clearly not what the country needs at the moment.

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  • What is it with these medical schools? They seem to think they exist entirely for their own satisfaction. Remove their funding.

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  • Agreed let them do research it would bore me to death I think.

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  • So the researchers who promote NICE guidance that is impractical in the real hands on clinical world come from an ivory tower background in an university that is unashamedly content to be an ivory tower.
    Think even the "red brick pleb GP" like me had already worked that out thank you.

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  • I find some of the above comments by GP colleagues unnecessarily aggressive. I think GP is remarkably intellectually interesting, combining use of insights from biomedical sciences, sociology, psychology, philosophy, art and literature. However there is value in having people who contribute from detailed understanding of all these fields, including the traditional biomedical sciences. Why not have medical schools that set out their stall, and are open about the emphasis of their course?

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  • 'maybe you should suspend that form of selection as it is clearly not what the country needs at the moment'

    Alright comrade! Universities should serve the requirements of the People as determined by the Party! The tall poppies must be culled lest they dominate the others! Lock up the bourgeois!

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  • "There is strong evidence that the GP recruitment crisis is related to deterioration in funding and working conditions in the specialty, and much less to what goes on in medical school."
    "If general practice is to compete with other specialities in attracting the best doctors, conditions and funding need to improve. Fix the job and the recruitment crisis will fix itself."

    He's absolutely right, why is anyone disagreeing with him?

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  • Yes - broadly speaking universities should serve the requirements of the people and of course research is part of that requirement but it is about getting the balance right .

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  • There are NO elite medical schools.

    Just ones that think, in error, they are above everyone else.

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